A major challenge in surgical operations has been control of blood flow. The presence of pooled blood at the surgical site can obscure a surgeon's view. Significant loss of blood can lead to shock and threaten the life of the patient. Many techniques to stop or reduce blood flow in surgery have been devised, but such techniques are often ineffective in conditions experienced during minimally invasive surgeries.
Among the techniques available to a surgeon for control of bleeding during surgery are suture ligation (stitches), electrocautery, argon bean coagulation, surgical clips, and application of pressure. These methods used alone, or in combination, can successfully control bleeding in many circumstances. However, these methods can be tedious and can distract the surgeon from the primary surgical task. Many of these techniques are ineffective or impractical in the case of laparoscopic surgery.
Recently, the application of coagulation potentiators has been used to help control bleeding during and after surgery. These potentiators can interact with platelets, and/or the coagulation cascade proteins of plasma, to provide blood flow barriers that promote healing and can dissolve during convalescence. Coagulation potentiators include fibrin glues, collagen sponges, artificial sponges, and the like. In many cases, these coagulation potentiators can be applied generally to stop multiple small bleeding sites or to stop bleeding at sites not localized with certainty. These coagulation potentiators commonly require a cleared and dried site for application. Although gross blood can be removed by suction, this practice may not be compatible with laparoscopic surgery. In addition, suction devices work locally on pooled fluids but can clog or seal on tissues, and are poorly suited to clearing and drying many surgically exposed surfaces.
Laparoscopic and robotic surgery have brought unique problems for control of bleeding and adhesions. For example, in laparoscopic surgery, bleeding can not generally be controlled by suctioning or application of pressure. In open incision style surgery, the surgeon could easily manipulate organs to apply coagulation potentiators and antiadhesive films. This is not the case in laparoscopic surgery. It remains difficult to deliver bioactive agents to surgical sites during laparoscopic surgery.
A need remains for methods to clear fluids from tissue surfaces during surgery and for immediate application of bioactive agents, such as hemostatic agents or antiadhesive agents. Portable, sterilizable devices for application of liquid or dry bioactive agents would be beneficial, particularly in the case of laparoscopic surgery. The present invention provides these and other features that will become apparent upon review of the following.